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P.J. McDonnell, J.J. Doyle, L. Stern, A. Behrens, Dysfunctional Tear Syndrome Group; A Modified Delphi Technique to Obtain Consensus on the Treatment of Dysfunctional Tear Syndrome . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3909.
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Purpose: To develop modern treatment recommendations based onconsensual expert advice for dry eye disease.Methods: Out of25 pre–selected specialists, a total of 17 internationalexperts in Dry Eye participated in a modified Delphi panel technique.Based on literature and standards of care, a survey was previouslypresented to panelists. A 2/3 majority was used for consensusbuilding from responses obtained. Treatment algorithms werecreated for the general ophthalmologist. Results: A new termfor the disease was proposed: Dysfunctional Tear Syndrome. Treatmentrecommendations were primarily based on patient symptoms andspecific clinical signs. Diagnostic tests were deemed secondaryin the election of therapy. Algorithms were developed dependingon the presence or not of of lid margin disease, and diseaseseverity (mild 1–2, moderate 3–4, and severe >4)was assessed according to use of tear substitutes, ocular fatigueand discomfort, and visual disturbances. View OriginalDownload SlideView OriginalDownload Slide In mild disease, conservative treatment may be sufficient, whilein moderate and severe levels, anti–inflammatory therapyis required. View OriginalDownload SlideView OriginalDownload SlideConclusions: Treatment alternatives for Dysfunctional Tear Syndromeare in expansion. Expert opinion stresses the importance ofsymptoms and signs to decide the most appropriate therapy foreach patient.
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